You can haggle with your doctor for your next surgery

Posted on September 10, 2018

By Michael Kaplan | New York Post

When Larry Nolan decided to fix his deviated septum — so askew that his nose was visibly crooked and airflow was almost nonexistent — he knew he needed to find a skilled plastic surgeon. He also knew he wouldn’t be paying retail.

The 34-year-old Californian, who co-owns the Hardcore Fitness chain of gyms, sought a price quote from the office of Dr. Robert Kotler, a highly regarded facial plastic surgeon in Beverly Hills. The initial estimate: $16,500. Nolan suspected he could negotiate a better deal.

More people than ever are haggling to reduce the cost of health care, spanning everything from annual physicals to major lifesaving surgery. And for good reason: A poll, co-conducted last year by the find-a-doctor site Amino.com, found that 55 percent of respondents had been hit with at least one medical bill they couldn’t afford to pay.

Abbie Leibowitz, founder and chief medical officer of Health Advocate Solutions, a company that advises consumers on health care and insurance needs, explains that out-of-pocket expenses are rising. Average deductibles for family plans came to $8,232 in 2017, according to eHealth Insurance. As a result, patients are devising creative ways to save cash. “If you are not attempting to negotiate, you are missing out,” Leibowitz says.

It helps to have a bargaining chip, experts tell The Post. Common points of negotiation include flexibility in scheduling, the ability to satisfy a bill quickly and — depending on your digital clout — a promise to promote the provider on social media. An expression of need can sometimes help, too.

Nolan negotiated a break by accepting a last-minute appointment when another patient canceled, agreeing to go under the knife with just five days’ notice. When the office manager asked what he’d be willing to pay for the spur-of-the-moment surgery, he said $12,000.

“They said they could do it at that price,” Nolan says — a savings of more than 25 percent.

For his part, Kotler tells The Post that he also considers markdowns for patients who sign on for multiple procedures at the same time or piggyback with another patient for what he calls “the friends and family plan.”

“If someone and her sister want work done and we can do it all in the same day, we offer a discount that can be 20 percent,” Kotler says.

Wheeling and dealing also works for dentistry. When Nolan needed crowns on his four front teeth, he scored a 50-percent-off deal in which he agreed to promote the dentist to the 150,000 Instagram followers and 5,000 Facebook friends he shares with his wife. “By posting pictures of me smiling on Instagram and tagging the dentist on Facebook, I brought the price down to around $4,000,” Nolan says. “And [the dentist] posted before-and-after pictures of me on her Facebook page.” Nolan estimates that his endorsements drove at least 20 new patients to the practice.

Ed Brodow, author of “Negotiation Boot Camp” and a negotiation consultant to Fortune 500 companies, says courage is half the battle. “It’s all about having the guts to ask,” he says.

Such was the case when he received a $2,000 quote for a dental crown. “I flinched and said, ‘That seems very high. I can’t afford that. Can you help me out?’ ” The dentist lopped 25 percent off the price.

“I knew he would rather get $1,600 from me than have me not do it or look for another dentist,” Brodow says.

Researching market rates can further empower patients in price discussions, says Derek Fitteron, CEO of Medical Cost Advocate, which aids clients in getting value out of health care. He suggests looking up average procedure costs on sites such as Medicare.gov and HealthcareBluebook.com and using those numbers as a starting point.

And don’t hesitate to negotiate if your bill doesn’t align with typical fees. “Call [the provider] and say, ‘You are charging me more than the going rate,’” Fitteron says. Doctors’ offices often acquiesce in hopes of securing payment more quickly, he notes.

In many cases, haggling after care actually gives you an edge. “That’s when you are in a position of power,” says Diane Mullins, a registered nurse with an MBA in health care management and the author of “Health Care & You: A Guide to Navigating the Health Care System and Becoming Your Own Best Advocate.” After all, the hospital can’t exactly take back your artificial hip.

Another gambit for getting a price cut after the fact: Offering to pay a smaller lump sum immediately as opposed to a larger amount in billed installments. This often results in a 15 to 20 percent discount, Fitteron says.

It can work even when your bill isn’t in the thousands. Leibowitz says that patients can haggle over co-pays, offering to pay a smaller amount on the day of their office visit. “You can offer to pay $20 on the spot rather than them billing you for $30,” he says. “The idea of getting paid right then and there is appealing [to doctor’s offices].”

As an entrepreneur himself, Nolan believes that health care is a numbers game like everything else. “Because doctors provide a medical service, people think that their prices are set in stone,” says Nolan. “But ultimately, they are also running businesses. And like all [businesspeople], they benefit from negotiating.”

West's Health Advocate Solutions makes healthcare easier for over 12,000 organizations and their members by leveraging a combination of personal support, data and technology to engage people in their health and well-being.